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Biomedical subjects

B L Mishara

Publications and source records attributed to B L Mishara.

At least 19 recordsLinked to original sources
PubMed1999

Suicide in the Montreal subway system: characteristics of the victims, antecedents, and implications for prevention.

OBJECTIVE: To understand the characteristics of persons who commit suicide in the Montreal subway system (the Montreal Metro), their personal and psychiatric histories, and the nature of the event in order to develop better prevention strategies. METHOD: Systematic analysis of coroner's office investigations of the 129 suicides in the Montreal Metro from 1986 to 1996. RESULTS: Of the 129 people who committed suicide, 81% had expressed a prior suicidal intention, 66% had previously attempted suicide, and 9% had attempted suicide in the metro. One hundred and five of the victims had serious mental health problems, most frequently depression; 73% had had inpatient psychiatric treatment, and at the time of death, 27% resided in a mental health treatment institution. Recent adverse life events included failed relationships, work problems, and family difficulties. CONCLUSIONS: Suicide victims intentionally go to the metro to kill themselves, often tell others beforehand, and are generally in treatment for serious psychiatric problems. Possible prevention strategies include modification of the environment and procedures in the metro, changing public conceptions of metro suicides, and modifying practice in psychiatric facilities.

Adolescent↗
PubMed1999

Conceptions of death and suicide in children ages 6-12 and their implications for suicide prevention.

Interviews were conducted with 65 public school children in Grades 1-5 concerning their understanding of and experiences with death and suicide, and investigating the development of the Piagetian concepts of life and age. By third grade, children have an elaborate understanding of suicide, and younger children generally understand "killing oneself," although their understanding of death and living may be immature. Children learn about suicide from television and discussions with other children, but they rarely discuss suicide with adults. The level of development of the concept of suicide is related to maturity rather than specific experiences. Implications for primary prevention are discussed.

Attitude to Death↗
PubMed1998

Suicide, euthanasia and AIDS.

This article critically reviews research on suicide, AIDS, and HIV seropositivity. Studies indicate that men with a diagnosis of AIDS or HIV seropositivity have up to 36 times greater risk of suicide than men without the diagnosis. Yet few studies controlled for independent risk factors such as premorbid or comorbid psychiatric syndromes. Also, control groups may not be appropriate, little data are available on women, and explanations of suicidal dynamics are mostly speculative. After a look at the research on the desire for euthanasia and assisted suicide with other illnesses, the author suggests alternative hypotheses concerning suicidality, the desire for euthanasia, and AIDS.

Bias↗
PubMed1997

Effects of different telephone intervention styles with suicidal callers at two suicide prevention centers: an empirical investigation.

To determine the relative effectiveness of telephone intervention styles with suicidal callers, researchers listened unobtrusively to 617 calls by suicidal persons at two suicide prevention centers and categorized all 66,953 responses by the 110 volunteer helpers according to a reliable 20-category checklist. Outcome measures showed observer evaluations of decreased depressive mood from the beginning to the end in 14% of calls, decreased suicidal urgency ratings from the beginning to the end in 27% of calls, and reaching a contract in 68% of calls, of which 54% of contracts were upheld according to follow-up data. Within the context of relatively directive interventions, a greater proportion of "Rogerian" nondirective responses was related to significantly more decreases in depression. Reduction in urgency and reaching a contract were related to greater use of Rogerian response categories only with nonchronic callers.

Adolescent↗
PubMed1997

[Family ecology and drug consumption by the elderly: a commentary on an important factor ignored in research and prevention programs].

A litterature review from 1986 to 1996 on medication use by older persons confirms previous conclusions on studies up to 1986 (Mishara and McKim, 1989): there is little empirical research on the role of family members in patterns of medication use by elders. This article briefly summarizes studies of factors related to medication use and prevention programs aimed at reducing problems related to compliance and drug adverse reactions in older persons. We propose a conceptual model of the role of the family as a component of resiliency of elders and we suggest that family members be included in strategies for preventing the risks related to inappropriate use of medicines.

Aged↗
PubMed1995

Individual differences in stimulus intensity modulation and its relationship to two styles of depression in older adults.

Research comparing depressive persons with and without manic symptoms shows striking parallels with differences between augmenters and reducers on the Kinesthetic Aftereffect (KAE) task (A. Petrie, 1967). Twenty-three community-dwelling older adults identified by the Minnesota Multiphasic Personality Inventory (S. R. Hathaway & J. C. McKinley, 1951) as depressive without manic symptoms were compared with 24 older adults with manic symptoms on the KAE, the NEO Personality Inventory (NEO-PI; P. T. Costa & R. R. McCrae, 1985), and Strelau (J. Strelau, 1983) Temperament Inventory. As hypothesized, augmentation was related to depression without manic symptoms, and reduction was related to depression with manic symptoms. Stepwise discriminant analyses indicated that the KAE is a potent discriminator between the 2 types of depression. Three characteristics of Strelau's "strength of nervous system"--excitation, and inhibition and mobility--discriminate significantly between the 2 groups as well as NEO extraversion and conscientiousness. Results suggest that older depressive persons with and without manic symptoms may benefit from different therapeutic interventions.

Aged↗
PubMed1995

Intervention styles with suicidal callers at two suicide prevention centers.

Callers to suicide prevention centers are mainly helped by volunteers trained to face these crisis situations. This study evaluated this process of intervention in order to better understand the nature of the interventions and their determinants. A total of 617 calls with suicidal clients were classified with a 20-category rating instrument, the Helper's Response List. Cluster analysis determined that the 617 intervention profiles could match one of two styles: nondirective ("Rogerian" -391 calls) or directive (226 calls). Further analyses indicated that the particular style of intervention was related more to the characteristics of the callers themselves than to characteristics of volunteers.

Adolescent↗
PubMed1993

Methodological issues in surveying older persons concerning drug use.

Despite beliefs that surveys involving older persons are less valid than those with other groups (due to memory loss, etc.), empirical verifications do not support this. Certain factors related to reduced validity must be considered (e.g., little education) and the confounding factors of cohort and time of measurement must be evaluated. Persons presumably suffering from dementia and institutional residents may be needlessly excluded. Methods suggested for improving validity include: sampling techniques, proxy respondents, administration and instrumentation, and interviewer variables. It is important to cross-validate data from surveys by using several concurrent methods. Instruments developed with younger subjects may be inappropriate or invalid with elders.

Aged↗
PubMed1993

The relationship between coping strategies and perceived stress in telephone intervention volunteers at a suicide prevention center.

This study examines stress perceived by telephone intervention volunteers at a suicide prevention center before their shift, during the most high-urgency call, and after the shift. Eighty of the 82 active volunteers completed questionnaires concerning stress, coping strategies, motivations for volunteer work, and experiences with suicide. Stepwise multiple regression analysis indicated that only one variable, the amount of experience in telephone intervention with suicidal persons, predicted stress level before the shift; volunteers with more experience tended to be less stressed. Stress during the most urgent call was related first to the level of urgency of the call, then to the total length of all calls received, followed by the coping mechanisms of magical thinking, detachment, and feeling personally responsible. Stress after the shift was related first to the total amount of time spent on calls, then to the number of other persons present during the shift. Stress after the shift was also negatively related to amount of education and having realistic expectations about interventions. Magical thinking was positively related to stress, and the mechanism of positive thinking was negatively related. A high proportion of volunteers had attempted suicide, had previous thoughts about suicide, and had known persons who attempted or died by suicide. These findings are discussed as to their implications for the selection and training of volunteers in suicide prevention.

Adaptation, Psychological↗
PubMed1986

Kinesthetic aftereffects and individual differences in carryover effects.

Prior research has found that individual differences in long-lasting carryover effects occur in the kinesthetic aftereffect (KAE) task both when the aftereffect inducing block was wider (I greater than T) and narrower (I less than T) than the test block. The present study found that such individual differences in carryover effects also occur for a no-aftereffect-induction control condition, with a magnitude approximately equal to that found for the I greater than T and I less than KAE variants used here.

Humans↗
PubMed1981

Individual differences in stimulus intensity modulation of the elderly.

The validity of the postulated perceptual style-personality dimension of modulation (augmenting vs. reducing) of stimulus intensity previously studied with young adults was examined in two elderly samples. It was hypothesized that in the elderly Stimulus Intensity Modulation (SIM) relates to degree of social engagement (assessed both behaviorally and by self-report), perceived life difficulty, attitudes toward death, and three previously validated behaviors (desired and obtained amount of sleep, future planning, and smoking). The Kinesthetic Aftereffect (KAE) task was used as the measure of SIM. Results from multivariate analyses of variance indicated a significant relationship between KAE and the validity variables. Additional correlational analysis indicate that there is a linear relationship between KAE and each of the domains, except attitudes toward death. Results from both studies are consistent with the views that KAE indexes the postulated SIM dimension and that the SIM approach can be applied fruitfully to the study of individual differences in the elderly.

Aged↗
PubMed1980

Bias in Petrie's alternate-form procedure for kinesthetic aftereffect.

Kinesthetic aftereffect, commonly administered with alternate forms given on two separate occasions, has been used to assess individual differences in personality and perceptual style. Recent criticisms have questioned whether this task gives a worthwhile measure of individual differences. This paper represents a further response to such criticisms by extending to Petrie's alternate-form procedure our argument that lack of test-retest reliability is associated with practice effects which differentially bias second-session scores. Findings indicate that second session bias does occur with this procedure, and, as expected, there was an inverse relationship between magnitude of retest reliability and differential bias. Although use of the alternative-form procedure is contraindicated, a single-session procedure remains a promising personality measure since it is not affected by differential bias.

Adolescent↗
PubMed1979

Menstrual cycle affects kinesthetic aftereffect, an index of personality and perceptual style.

Research suggests that kinesthetic aftereffect (KAE) scores reflect status on a postulated stimulus intensity modulation (SIM) mechanism that damps down subjective stimulus intensity for some (reducing) and increases it for others (augmenting). Such a mechanism would help account for empirically observed individual differences in such behaviors as pain tolerance, sensory deprivation reactivity, and stimulation seeking. It was hypothesized and confirmed in three adult female samples that KAE varies curvilinearly over the menstrual cycle: Greater KAE reduction occurs at the cycle's beginning and end. Neither tiredness, oral contraception, medication, attention, nor social expectations can explain this finding. Of the behaviors studied in the KAE literature, only five are also encompassed by the menstrual cycle literature. Four of these (antisocial behavior, acute schizophrenic episodes, accidents, and activity level) show similar curvilinearity over the cycle. We hypothesize that cyclical variation in the SIM mechanism mediates the curvilinear pattern observed for both these four behaviors and KAE.

Adult↗
PubMed1979

Environment and face-hand test performance in the institutionalized elderly.

Long term institutionalized elderly people were tested over nine months on the Face Hand (FH) test. Orinally other neuropsychological tests also were to be given, but most patients could only respond to FH at first. Experimental subjects were transferred either to an enriched stimulation environment or a token economy program while control subjects remained in custodial care settings. Analysis of variance interaction between experimental condition and time of testing indicated significant improvement in performance in the enriched environment compared to the token economy and control groups. In supplementary analyses on a subsample capable of other tests at the end of nine months, FH correlated significantly with some neuropsychological measures and not with social skills.

Aged↗
PubMed1976

Kinesthetic aftereffect and personality: a case study of issues involved in construct validation.

Kinesthetic Aftereffect (KAE), once a promising personality index, has been abandoned by many investigators because of poor retest reliability and intermittent validity. In challenging this current consensus, we argue that (a) first-session KAE is valid; (b) poor retest reliability simply reflects later-session bias; (c) hence, multisession studies should not be used to assess validity without taking this bias into account. Those recent studies which failed to support KAE validity were each multisession in design. If our bias contention is correct, these studies should be ignored, and the claim of intermittent validity is thus rebutted. Reanalysis of the most recent major multisession, nonsupportive validity study indicates (a) Session 1 validity, (b) later-session bias, and (c) later-session valdiity when multisession scores are combined to avoid bias. Thus, KAE validly measures personality.

Humans↗